Clinical T

This input is used for staging


**Note 1:** Non-invasive carcinomas in the esophagus formerly called in situ are now called high grade dysplasia. High grade dysplasia and severe dysplasia are generally not reportable in cancer registries. * Assign pTis if your registry collects these tumors **Note 2:** Ignore intraluminal extension to adjacent segment(s) of esophagus or to cardia of stomach and code depth of invasion or extra-esophageal spread as indicated. **Note 3:** The three layers of the mucosa (epithelium, lamina propria, and muscularis mucosae) may be called the m1, m2, and m3 layers. The submucosa may be described as having inner, middle, and outer thirds called sm1, sm2, and sm3. **Note 4:** If the diagnosis states linitis plastica and no other information regarding primary tumor is available, assign T1. Linitis plastica is defined as diffuse involvement of the entire stomach wall. **Note 5:** Assign T4a for contiguous extension from the site of origin. Discontinuous involvement is coded in distant metastasis.except for implants within the stomach (T1).


Clinical T Clinical T Display Description Registrar Notes
cX cTX Primary tumor cannot be assessed Clinical classification criteria met, evaluation done:
Physician unable to assess T
Extension cannot be determined
Physician assigns cTX, no other information available to determine T
c0 cT0 No evidence of primary tumor
pIS pTis Carcinoma in situ/high-grade dysplasia Non-invasive

(Adeno)carcinoma, noninvasive, in a polyp

Stated as Tis
c1 cT1 Tumor invades:
Lamina propria
Muscularis mucosae
Note: T1 has subcategories of T1a and T1b. Assign T1 only when there is no information available to assign one of the subcategories

Tumor in polyp, NOS

Implants inside stomach

Localized, NOS

Stated as T1 [NOS]
c1A cT1a Tumor invades lamina propria or muscularis mucosae Invasive tumor confined to mucosa, NOS (including intramucosal, NOS)

Invades lamina propria or muscularis mucosae

Stated as T1a
c1B cT1b Tumor invades submucosa Stated as T1b
c2 cT2 Tumor invades muscularis propria Invades into but not through muscularis propria

Linitis plastica (and no other information regarding extension available)

Stated as T2
c3 cT3 Tumor invades adventitia Extension through wall, NOS
Invasion through muscularis propria or muscularis, NOS
Perimuscular tissue invaded
Subserosal tissue/(sub)serosal fat invaded

Adventitia and/or soft tissue invaded
Esophagus is described as "FIXED"

Extension to adjacent (connective) tissue WITHOUT perforation of visceral peritoneum covering these structures:
Gastric artery
Omentum, NOS
Perigastric fat

Stated as T3
c4 cT4 Tumor invades adjacent structures Note: T4 has subcategories of T4a and T4b. Assign T4 only when there is no information available to assign one of the subcategories

Stated as T4[NOS]
c4A cT4a Tumor invades:
Invasion of/through serosa (mesothelium) (tunica serosa) (visceral peritoneum), including:
Perforation of visceral peritoneum covering the gastric ligaments or the omentum WITHOUT invasion of adjacent structures

Abdominal wall
Adrenal gland

Stated as T4a
c4B cT4b Tumor invades other adjacent structures such as:
Vertebral body
Tumor invades adjacent structures:
Duodenum via serosa
Duodenum, NOS
Esophagus via serosa
Small intestine, NOS
Transverse colon (including flexures)

Stated as unresectable, NOS

Stated as T4b
88 88 Not applicable Primary site/histology not TNM defined
Death certificate only (DCO) case
<BLANK> BLANK See Registrar Notes Clinical classification criteria not met
Clinical classification criteria met, evaluation done:
No information about diagnostic workup
Results not documented in record
Clinical evaluation of primary tumor not done or unknown if done
Tumor first detected on surgical resection (no clinical workup)
Evidence of metastatic disease [(cM1) or (pM1)], no other workup
Only Clinical Stage Group documented (no T, N, or M information available)